Yes, NHIMA belongs to MOH – Dr Chitalu Chilufya
…That’s the original design
Lusaka—Friday, March 29th 2024
SMART EAGLES
Former Minister of Health in the Patriotic Front, PF, government, Dr. Chitalu Chilufya says the UPND government is on firm ground in its decision to move the National Health Insurance Scheme, NHIMA, from the Ministry of Labor and Social Services back to the Ministry of Health.
Dr. Chilufya says the move constitutes the initial step needed to realign NHIMA to its original design and purpose as an innovative health care financing strategy and a tool that must lead towards the achievement of Universal Health Coverage, UHC.
“NHIMA is a robust, resilient, and sustainable tool to finance health services for all, leaving no one behind. It’s a vital pillar in any functional and well-structured national health system that targets UHC”, Dr. Chilufya says.
The former Health Minister and Member of Parliament for Mansa Central Constituency says NHIMA was structured to forge important significant synergies with the Zambia Medicines and Medical Supplies Agency, ZAMMSA, and other departments and directorates with the capacity to audit and ensure quality public health and clinical care for citizens. For this reason, Dr. Chilufya says NHIMA must be domiciled under the Ministry of Health where it may be supported by health-related legislation such as the National Health Insurance, NHIS, Act.
Now that NHIMA is where it rightly belongs, Dr. Chilufya says the urgent imperative of the moment is to improve service delivery in all public health institutions to assure high quality health care services for all and as close as possible to where they may be. He says all medicines must be available in public health pharmacies and dispensaries so that members of the public are not referred out with prescriptions.
Furthermore, the Mansa lawmaker says laboratory and diagnostic services need urgent attention while keeping the relevant equipment in a functional state so that they may undertake a comprehensive scope of investigations in line with the level of accreditation of the various facilities. For this task to be accomplished successfully, Dr. Chilufya says laboratories must be restocked with reagents.
In addition, the former Minister says there is need to strengthen leadership and governance for Universal Healthcare at NHIMA. “We must continuously review the benefit package to align with our epidemiological profile, primary health care priorities and a deliberate bias towards public facilities”, he says.
He suggests the need to relaunch the registration drive using community structures under the Ministry of Health and its partner ministries. He also says there is need to ensure solvency of the fund by reviewing contributory rates and the claims being paid by NHIMA. This way, Dr. Chilufya says NHIMA will adequately supplement finance of public health institutions through claims while private facilities will complement access to health services.
“NHIMA must ease public health care financing to ensure health services reach the young, the old, non-employed, the employed, the retired and the old and vulnerable people. Anything deviant runs counter to the intention NHIMA was promulgated and flies in the face of the National Health Insurance Act No 2 of 2018”, Dr. Chilufya observes.
Since Zambia returned to multiparty democracy in 1991, successive governments have attempted to introduce health insurance in the country. However, it was in 2018, when Dr. Chilufya was Minister of Health when the NHIMA became a reality supported by an act of parliament.
In October of 2021, the UPND government moved NHIMA from the Ministry of Health to the Ministry of Labor arguing that it was a social security issue. However, last year, the government rescinded the decision and began the process of returning the scheme back to the Ministry of Health where it originally sat.
Nhima is run like a Pension scheme. And being an agency run like an entity, Dr Chilufya has got it wrong.
Medicare and Medicaid is run as part of an agency Social Security. In the UK national Insurance scheme which cover issues like Pension and Health costs.
Yes the two over the years seem to have failed as the worker contribution has fallen due to the fact that folks are living longer and the working population contributing to these “funds” is falling (low birth rate). In the Zambia case the contribution is low because of the same issue that plagues the tax contribution.
The public accessible blurp that I read on the News Diggers didnt explain the reason for the MOH take over. Neither does this article give a rational reason for the move other than portifolio which to me is vague and irrational.
Most of our state structures and quasi givernment agencies are a duplicate of what has worked in other countries whom we got independence from.
Ba UPND before making structural changes share policy papers for public comment. These changes may work out to be expensive and not solve the reason why the move is being made.
Sustainability is what you should strive for. Address the issues of contribution, the accounting issues of payments to health institutions, funding, payments to health care providers are better done by the agency and if there is a problem between the government and the contributions administration/payments a unit at the Ministry of health/labour can address that. But let Pension like contributions be run and regulated by folks that understand the laws and area.
NHIMA from a conceptual form is doing fine. You have had issues of folks at Min of Health focusing on the Monetary gain (donor funding) than the provision of health service. Insurance and its administration will just detract health care providers from Providing that to the monetary aspect. And quality of service provision will be affected.